| Japanese |
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| Title | 99mTc-MAG3血漿クリアランス法の精度向上の試み : 循環血漿量の算出法の問題点と改善 |
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| Subtitle | 技術報告 |
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| Authors | 渡邉奈美*, 高橋和栄**, 駒谷昭夫*, 山口昂一* |
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| Organization | *山形大学医学部放射線科, **山形大学附属病院放射線部 |
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| Journal | 核医学 |
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| Volume | 35 |
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| Number | 8 |
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| Page | 741-747 |
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| Year/Month | 1998/10 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」 99mTc-MAG3血漿クリアランス法(MPC法)は, 簡便で有用な腎摂取率法であるが, その99mTc-MAG3血漿クリアランス(CLMAG)と, 1回の採血による血中クリアランス法のRussellらの方法により求めた尿細管抽出率(TER)が乖離する場合がある. 原因を循環血漿量の算出法と考え, MPC法で用いられている小川の式を体表面積より算出するDissmannの式に代えたmodified MPC法を考案した. 95症例でMPC法とmodified MPC法によりCLMAGを算出し, 各々Russellらの方法によるTERとの相関を検討した. MPC法とRussellらの方法との相関は, 全体ではr=0.82, p<0.0001と良好であったが, 男性群と女性群では回帰式の傾きに差を認めた. Modified MPC法では, 全体ではr=0.92, p<0.0001であった. MPC法は回帰式に男女差があり, 精度を下げていると考えられた. その原因が小川の式を用いた循環血漿量の算出法にあることを検証した. MPC法は, Dissmannの式で循環血漿量を求めることにより, 男女・小児とも精度の著明な向上が得られた. |
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| Practice | 臨床医学：一般 |
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| Keywords | Kidney, 99mTc-MAGi clearance, Count-based gamma camera method, Plasma volume |
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| English |
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| Title | Improved the Accuracy of 99mTc-MAG3 Plasma Clearance Method : The Problem of the Calculated Plasma Volume and Its Modification |
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| Authors | Nami WATANABE*, Kazuei TAKAHASHI**, Akio KOMATANI*, Koichi YAMAGUCHI* |
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| Organization | *Department of Radiology, Yamagata University School of Medicine, **Department of Radiology, Yamagata University Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 35 |
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| Number | 8 |
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| Page | 741-747 |
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| Year/Month | 1998/10 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] The 99mTc-MAG3 plasma clearance method (MPC method), reported by Oriuchi et al., is a simple and useful count-based gamma camera method for calculating the 99mTc-MAG3 plasma clearance (CLMAG). However, a discrepancy of CLMAG calculated by MPC method (MPC-CLMAG) from the tubular extraction rate (TER) calculated by Russell's single-sample clearance determination (Russell-TER) was noted. The calculated plasma volume is assumed to be the cause. Since the plasma volume is reported to have a linear correlation with body surface area, Dissmann's formula was applied to calculate the plasma volume. Then Dissmann's formula was replaced by Ogawa's formula in the MPC method, and the procedure was then called the modified MPC method. The CLMAG were obtained using MPC method, modified MPC method and the TER was obtained Russell's method in 95 patients with urological disorders. Then the MPC-CLMAG and modified MPC-CLMAG were compared with Russell-TER. Comparison of the MPC-CLMAG with the Russell-TER demonstrated a coefficient of correlation of 0.82, but dissociation of the slope of regression lines was found between males and females. The modified MPC-CLMAG improved the coefficient of correlation to 0.92, and diminished the dissociation of the slope of regression lines between males and females. We verified that the dissociation was due to the plasma volume calculated by Ogawa's formula. Ogawa's formula included hematocrit, body weight, body height and different coefficients for gender. The plasma volume calculated by Ogawa's formula were lower in males and higher in females than that calculated by Dissmann's formula. And marked discrepancy in the plasma volume in patients with a body surface area below 0.5 m2 was observed. So the MPC method might become more accurate by substituting Dissmann's formula for Ogawa's formula resolting in a method that is applicable to both males and females, children and adults in clinical use. |
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| Practice | Clinical medicine |
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| Keywords | Kidney, 99mTc-MAGi clearance, Count-based gamma camera method, Plasma volume |
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